The following images are from patients undergoing chemotherapy, who have uncontrolled HIV, or who are taking high dose steroids. They all presented with seizures or focal neurologic signs.
This CT was obtained in a patient who had a stroke.
Challenge: What's the diagnosis?
Images shown under Fair Use.
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Holy Water Sprinkler
An aspergillum is a liturgical instrument used to sprinkle holy water, and its shape resembles that of Aspergills under the microscope. The first image shows multiple ring-enhancing lesions with surrounding edema and mass effect. The second image shows abnormal soft tissue filling the ethmoidal air cell complex, nasal cavity, and maxillary sinus; the arrows show dural thickening and abnormal enhancement. The third image shows Aspergillus thrombosis and vascular invasion. These all show aspergillus CNS infection.
Source: UpToDate.
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